Category: Houston: BCM and DGH

We almost did not move to Houston. Karen and I made a house-hunting visit there, once I had been offered my tripartite position at Baylor College of Medicine (BCM). We wanted to live near the College, probably in the University Area surrounding Rice Village. The area adjoined the Texas Medical Center which, itself, encompassed BCM. The TMC had a concentration of medical institutions (hospitals as well as medical schools) greater than that found anywhere in the nation, even Boston. This part of town seemed to be ideal, at least in appearance and location.

Rice University, itself, was certainly an example of “Southern-Ivy-League.” The campus had the collegiate architecture of other campuses we had encountered: a combination of red brick and brown-gray sandstone, with long colonnades and tree-lined quads. Rice had an excellent reputation as a private school; if it had been located in New England instead of south of downtown Houston, it would have been a member of the true Ivy League. Memorial Park, with its zoological and botanical gardens, was close-by. Rice Village, per se, was a charming, stereotypical college town. Moving from Amherst to this location would not be a hardship. Except for one factor: the cost.

Every house we were shown by the realtor was double or triple the price of anything we had ever known. We thought there was no way we could financially afford a move to Houston, despite the significant increase in the salary I was being offered. We had almost decided we would not move. Fortunately, however, we had been invited to dinner by Anita and Tony Gotto, who was chairman of the Department of Medicine and instrumental in my coming to BCM. When they had moved here, their first home was in an area north of Houston, known as the FM 1960 area. They urged us to look there.

Our replacement-realtor began to show us homes we could afford. Although they cost more than anything in Amherst, they were in a range that was “thinkable.” We finally found one on Grand Valley, in a development called Ponderosa Forest. What better address could we want for a life in Houston, Texas! Actually, it would not be in Houston, but rather in Spring, Texas, a suburb in the surrounding Harris County. We soon learned several new concepts.

First of all, it was difficult to determine where Houston left off and Harris County began. The difference was much less than we had once experienced among Washington, D.C. and its surrounding cities in Maryland or Virginia. Second, we would be living about thirty miles north of where I would be working; this demanded a commute which would, on a good day, take about an hour. The travel-time, I found, would be doubled when an accident occurred on I-45, the main highway from the north. Third, Interstate 45 would always be under construction. The initial roadwork had begun at least a decade before our move; under the term “reconstruction,” it would still be incomplete some five decades later!

At least, we would now be able to afford a move to Texas. Besides, the location was ideally north of the city so that the daily commute would avoid my driving into the direct sunlight during a morning journey to work or homebound in the evening. We could be very content living in the FM 1960 area, named for the number of the Farm-to-Market Road we traveled daily for trips to the stores and commercial buildings required as part of a suburban existence.

Our new home was very different in style from anything we had lived in previously. It was a New Orleans Colonial with a front balcony and wrought-iron railings; the exterior wood was light yellow with black ironwork; the bricks well-worn. We enjoyed sitting on that balcony on weekend mornings, or in the evening, with a cup of coffee. I smoked a lot of cigarettes there, stopping only some twenty years later when I had retired and we had moved to a new house in Cypress, Texas.

Although it was a comfortable house, which held all of our Early American colonial furniture and possessions from New England, Grand Valley, for me, did not really replace the beloved home where we had lived in Amherst. My nostalgic feelings about a place to live, comfortably, in Texas, were finally replaced when we sold our French Colonial and moved, several years later, to Cypress, Texas.

I had hoped the actual process of moving to Houston might offer me an opportunity to “bond” with Ken and it did. He had recently turned fourteen and I thought that time together, before the rest of the family joined us at the end of July in 1977, would allow us to develop a better relationship than the one I had with my father when I was a teenager.

We stayed at the Holiday Inn near the airport. Our plans called for us to transfer to a local motel on Main Street, only a couple of blocks from Baylor Med where I would be employed at the beginning of the following week. The Tides II motel offered a more reasonable weekly rate than the tourist site near the airport.

The morning after our arrival, I left Ken at the Holiday Inn to drive the short distance to Spring, Texas and the FM 1960 area where we would be living, once the moving van arrived with our belongings. Back then, the Farm-to-Market Road with the number “1960″ was a relatively quiet, suburban area some 30 miles from the Medical Center where I would be working. I needed to go to the Jetero Bank to check on the transference of funds from Massachusetts and to meet with our realtor to confirm that the paperwork for buying our new home in Ponderosa Forest was on track.

On the way to Northwest Houston, I thought the car lacked pick-up. As I slowed down to pull into the realtor’s parking lot, the brakes felt very soft, and the brake-light came on. When I got out of the car, I smelled burning rubber and saw smoke enveloping the rear wheels. I had been traveling at 60 mph for the fifteen-minute drive from the airport with the emergency brake engaged! The damn brake-light had never turned on! Somewhat concerned about the spiraling smoke, I quickly asked for a recommendation for a handy garage. The people at the realtor’s office suggested a place called Power Pak, a block away. I immediately followed their suggestion.

The service man in the garage put my car on the rack and tried to pry off the hub caps which were too hot to touch. He suggested a new brake job might be needed at $60.00! Oh well, what’s money, I thought. I had half-expected something like this would have happened. On our way to Ohio from Syracuse, where we had dropped Deb off at the university she would be attending, a similar unreleased brake caused overheating, but without the smoke! The current, potential repair would not be finished until at least 2:00 P.M. They offered to have one of their young employees drive me back to the Holiday Inn to get Ken and check out. I accomplished the transactions, and we were ready to return to the garage, but first we had to ask the motel’s maintenance man to jump the battery on the garage’s tow truck!

While we waited for the repair to be completed, Ken and I wandered around the Ponderosa shopping center and had a Whataburger, a ‘burger that was totally new to us! Upon returning to the service station, I learned that, once the brakes had cooled down, the mechanic thought they would not need to be replaced. And there was no charge for anything! Now that’s Texas, I thought.

We then drove to the Jetero Bank. The funds I had transferred from Amherst had been received and were available for use. In addition, our application for a car loan had been approved. All the Texans we met seemed to be very accommodating; I thought this might be a very good move for us, after all.

Ken and I then went to Lone Star Ford and bought a Pinto, at a total price of $3,787.51, after negotiations. Officially, the color was light green, but to my eye it was yellow. We would pick it up once Karen and the family had arrived.

That evening, Ken and I checked into the Tides II. (It might be noted that Tides I was a few blocks away!) He liked the pool and location, but the usual southern scuttling insects in this motel were a little more noticeable than at the Holiday Inn. Later, I learned these critters were “German cockroaches” and were associated with surrounding trees and not with the filth of the northern species. Nevertheless, they were still icky!

On the other hand, the surrounding odor of Tides II was significantly better than what we had encountered at the Holiday Inn. We decided it was circling airplanes that give the Inn its pungency and precluded outside activity around the pool. In LA it would have been called smog. We also went that evening to the Galleria to look around, marvel at its indoor skating rink, and have a Mexican meal. Ken decided he did like real tacos.

Ken was very good during our early days sharing a motel room. We had some differences but no major problems. I was glad he had come along. Our only consistent problem was he spoke so low I had to ask him to repeat half of what he said! All in all, I think he liked Houston, but his visible enthusiasm was underwhelming most of the time.

In the evening he watched TV while I poured over maps of Houston to determine where we had been driving on all of those intertwined freeways. I planned to do more exploring on the weekend when I thought the traffic might be lighter. I quickly learned that Houston traffic is never “lighter,” except, maybe, at 3:00 a.m. Nevertheless, we did do some exploring during the next few days.

Ken and I survived our first weekend in Houston. Fortunately, Saturdays in Texas were like weekdays in New England in that everything was open. In the Northeast, the weekend was for rest and relaxation, not for business or shopping.

We once more journeyed to Spring from the Med Center. I was able to make the final arrangements with the Jethro Bank for a car loan and was given the name of an independent insurance agent, John Nanninga. As it turned out, John remained as our agent for the next twenty years. Although he was from Chicago, he acted more like a “good-ol’-boy-Texan,” a trait I found to be true for other friends who came from the Windy City to Houston. Later, when Ken and Chris had to get their own driver’s insurance, John gave them his standard lecture on safe driving, before adding them to my policy. However, back in July 1977, he presented me with information I had never heard about before: flood insurance and something called the “hundred-year flood plain.”

I learned that Grand Valley Drive, where we were to live, was the last street on the flood plain, and, thus, flood insurance was mandatory. However, John said we could get it transferred from the current owners and would save some funds by doing it this way. Twelve years later when we had a foot of water in our house, after tropical storm Allison had sat over us for a day or two, we learned the full meaning of the value of flood insurance. But back in 1977, the expense was “just-one-of-those-necessary-things” that were part of moving into a different region of the country. At least the insurance for the old Mercury and the new Pinto would cost less in Texas than in “Taxachusetts.”

The discussion with John took an inordinate amount of time (for me, but evidently not for John.) Ken and I finally had breakfast about two o’clock in the afternoon.

My journal notes, which I have used to recall this particular adventure, indicate we also went to a place called Target, which I compared to a local Zayers or Bradlees, similar sites in the Northeast. There we purchased hangers, since our motel had an insufficient count. We also bought socks for Ken, who had not brought enough with him, and another pair of short pants. With his own money, he bought a football.

That evening, as Ken watched more television, I found a Laundromat in Rice Village, being thankful for the presence of a college-town atmosphere with such amenities. On the way back to the motel, I stopped at a place called Jack-in-the-Box, which I described as being like Hardees, to bring back a late dinner for us. Having done this, Ken would not need to leave the room and miss his programs as he had to do the night before, an apparent hardship resulting from the time differential from the East Coast. Once again, he did not like the JitB version and I gave him a buck, according to the journal, so that he could get something from the Burger King next door to the motel.

Ken had two ongoing problems. He did not like the new choices for fast-foods, and he dramatically objected to my smoking in the motel room we shared. To keep our disputes to a minimum, I did not smoke in our room after his complaints but enjoyed sitting by the outdoor swimming pool in the evening and staring up at the flood-lite palm trees, the likes of which were radically new to my historical view of where to relax on a quiet evening in midsummer.

On Sunday morning, I tried to find the Cathedral (actually the co-cathedral since the bishop is really in Galveston rather than Houston) but got confused and ended up at Holy Rosary, a Dominican church of a traditional bent. Ken had no interest in attending mass in the Cathedral and stayed in the motel; I did not make an issue of his preference; I was, finally, learning how to keep arguments to a minimum.

That afternoon we did drive through downtown Houston to gaze up at the tall buildings, a past-time for country folk which we still were. We stopped at the Hyatt Regency Hotel and rode up the 30 floors in the glass elevator, an impressive activity as far as Ken was concerned.

Late afternoon, we returned to the motel for some sun and swimming. The temperature on the building down the street said 100 degrees on its outside thermometer, but it didn’t seem as bad today as it had the day before. The humidity must have been lower today; I was very thankful for air conditioning both in the room and in the car. Yes, we were, indeed, no longer living in the Northeast.

Ken, at age 15, was the usual malcontent teenager. Kip, only two years behind, was not quite as easily vexed as his brother; or at least he did not exhibit the tendency as readily, although they continued to have their own sibling conflicts when Karen and I were not in the immediate area. Or was it arena? Nevertheless, I thought it would be appropriate for the three of us to experience a mutual, week-long vacation. The boys wanted to see the real Texas with its real cowboys – and maybe an Indian or two. They certainly had not yet encountered anything that resembled what was found in the movies claiming to have been made in their new state.

I did have a plan for an attempt to keep Ken from griping about the places we might see when we traveled to West Texas. Perhaps Kip would go along for the ride. He would have the entire back seat of the Pinto to himself, as Ken rode shotgun.

My plan was very simple. Ken was to determine which places we would see and where we would stay. He could, therefore, not blame anyone else if something was not to his liking. The rule for the adventure I proposed was that we would drive for a couple of hours to a site Ken would choose for a one or a two-hour visit or an overnight stay. This meant that we would see a mid- to late-morning location and another one in mid- to late-afternoon. Our lunch-stop would be determined by how long we stayed to view the midmorning and afternoon sights. This mealtime might or might not include an opportunity for sightseeing. We would stop early enough in the day to find a motel where we could remain overnight. There was no demand that we sleep in a place where there were things to see; swimming in a motel pool would be sufficient for them while I relaxed with a drink nearby.

Ken was presented with a Mobil Travel Guidebook for his scheduling endeavors. My guidelines worked! He did find interesting places none of us complained about, even if we never did locate the meteor crater near Odessa or any dinosaur-fossils, although the pump in one oilfield, from a distance, did resemble a medium-size, feeding dinosaur. On the other hand, given some other unexpected events, this was probably an advantageous omission.

Our first stop was for a foggy photo-opportunity at Washington-on-the-Brazos, the place where the Republic of Texas took form in 1836. Then on to San Antonio, with its Mexican mission buildings and River Walk. Although we investigated the real Alamo, our itinerary called for us to head west to Alamo Village near Del Rio. This tourist trap was the location for many western films, especially ones in which John Wayne had starred. The fake ruins were great for staging gunfights and for us to gain an appreciation for what the “real Texas” had been like. The boys even had the chance to be photographed with a stagecoach and badmen.

We then drove north to return to Interstate 10 and the true-western towns of Fort Stockton and Balmorhea, where we could swim in the spring-fed pool found in the local, state park. The water, not overly warm, was more green than the blue found in chlorinated motel-pools. The boys seemed to enjoy it with only minor objections. I, myself, did not like the feel of the scuzzy bottom.

El Paso and its mountain, along with the obligatory tramway-gondola ride, were the sights for our next adventure, which really occurred when we walked across the bridge to Ciudad Juarez, having paid our two-cent crossing fee. Back then, the journey did not require a passport for reentrance to the states. We found Mexican food was not all that different from what we had eaten in the Galleria in Houston. But the atmosphere was magnificent, even if somewhat dustier than what we had observed in San Antonio’s markets.

We left El Paso and made our way north, to the Carlsbad Caverns. This may have been the highlight of the trip. Although we had visited caves in parts of Texas and in Appalachia, nothing quite compared with those caverns of New Mexico. We hiked through its natural entrance, thankful that, in daylight, most of the bats had left the open cave. Finally, we arrived in the Big Room and witnessed the giant stalactites, stalagmites and fluted columns nature had formed over thousands of years. I wondered if, by placing my hand between the tips of those pyramids hanging down and those rising up, I could momentarily halt the earth’s evolution. None of us tried; we obeyed the guides’ instructions not to touch any of the living parts of the caverns.

Having passed through fairylands, castles and cathedrals glistening under a spectrum of artificial lighting, we had the chance to stand in absolute darkness and witness the diffuse colors washing through our retinas without external stimulation. At last, we rested in the subterranean cafeteria where we slowly consumed well-preserved, fossilized deli sandwiches, before squeezing into the upward-bound elevator and returning to the visitors’ center on the dry ground of New Mexico.

We continued our drive to the northeast and re-entered Texas. We beheld an environment that reversed what we had contemplated underground. We were now bewitched by the sky, by the blue dome of West Texas, with its strange, flat-bottom clouds looming into the atmosphere. Their cottoness captured every drop of available moisture and released none of it back to the parched earth, on which wind-devils and tumbleweeds danced as we crossed the flat plains crawling toward a distant, unapproachable horizon.

I am now unable to recall what other places we encountered in West Texas and the Panhandle. I don’t think we went as far north as Amarillo. We endured the flatness around Midlands and Odessa before making our way toward San Angelo and a stop in its newly created Holiday-dome. We returned to Houston at a pace much faster than Ken’s original itinerary had suggested.

While making our way through the last stages of our exploration of the caverns, I had begun to feel ill. I experienced an upset stomach, perhaps due to what I had eaten in Ciudad Juarez the day before. Within the next twenty-four hours my abdominal pains had not been relieved. I thought we probably should return home as soon as possible. We made the long drive from San Angelo to Houston with merely a stop or two for food for the boys.

The day following our return from our West Texas adventure, I went to work, as usual, in my office in the Fondren Building of The Methodist Hospital, in which the BCM Department of Medicine was located. Fortunately, the chief of the Gastroenterology division within the Department was in his office, around the corner from mine. Since my eyeballs and skin had taken on a very jaundiced tint, I thought I probably should get an informal consultation from him. With one glance at my yellow appearance, he gave me several immediate instructions: “Call your wife and have her pack a bag for you. Get in a wheelchair for a ride to Admissions at Methodist. You’re going to have your gall bladder removed as soon as possible.”

I returned home ten days later.

If I had endured the vacation the boys and I took in West Texas for a day or two longer, I would probably have died. The extremely jaundiced condition I presented to the chief of the Gastroenterology division of the Department of Medicine on the morning after I had returned to Houston suggested, I had a high level of bilirubin, a measure of a digestive malady. A test indicated this product was about ten times higher than it should have been. I was on the verge of a ruptured gall bladder, when I was confined to a room in The Methodist Hospital where I had to wait while the bilirubin declined to a point where removal of this inflamed and now useless organ might be possible.

The chief of the Surgery division at TMH finally agreed he would attempt the operation. It went well, but he did give Karen a terrible scare at the time, according to her account of their interaction. She had been waiting for several long hours in the lounge assigned to worried families and friends of patients undergoing surgery. During this time, she had observed surgeons coming out to tell those concerned that the operations had been successful. At last, she was told that my own surgeon would meet with her, but not in the general waiting room. They would talk in a nearby small, private location. She was certain bad news awaited her. As it turned out, he was offering a professional courtesy of meeting with her in private. The surgery had, indeed, been successful; she would see me shortly; and she did.

Given the severity of my condition before the operation, I needed to spend several days in the hospital, before and after the gall bladder removal. Since I had been the Administrator of Internal Medicine for the prior year and knew all of the department chiefs for the multiple divisions within Medicine, I had many professional visitors during this recovery period. The nurses were greatly puzzled by the high number of internal specialists seeking to review the chart hanging on the foot of my bed. Fortunately, none of them billed me for a consultation. Actually, much of the billing was lowered, again, as a professional courtesy.

I should not have been surprised by my own need for this surgery. Many years ago, my maternal grandmother had her gall bladder removed. She had to have a drainage tube attached to her body for a long time afterwards. My own mother was more fortunate. She had no drainage tube when her gall bladder was removed. I expected a similar, improved result.

When I returned home, I was welcomed by a movable hospital bed on the first floor of our house. I was also given the opportunity to hug a pillow for most of the time I spent there to counteract the pain associated with all of the healing stitches.

For surgeries performed currently, the incision for the removal of a gall bladder is very small. But forty years ago, this was not the practice. Since my surgeon had convinced me that my appendix should be removed at the same time as he disemboweled me of my gall bladder, the final incision was at least a foot long. My major problem occurred when Ken and Kip saw the scar shortly afterwards and exclaimed “Shazam” in honor of Captain Marvel’s lightning bolt! My laughter almost caused the stitches to pull apart. However, they did hold, and the boys were instructed to restrict their levity in the future.

I did, on the other hand, learn one very important fact and admonition. Never have elective surgery in the months of June and July. This is the time of the academic-medical year when new residents appear in a teaching-hospital. Although a new surgeon needs to learn how to enter and exit the human body, it is better that they practice on “someone else.” The results of my personal neophyte remain visible to the current day. Every personal physician I have encountered since then has the same initial inquiry: “What happened to you?” I seldom have gone shirtless during the last four decades.

Baylor College of Medicine truly gave me “full-time employment.” During my twenty-year career with the College, I usually held three simultaneous positions: Administrator for the Department of Medicine, Director for Faculty Resources, and Administrative Director for the Heart Center. The institution did know how to get the biggest bang for its buck. I like to believe that BCM, besides keeping me extremely busy, did receive some value from my years with the school.

In retrospect, it’s difficult to describe what I did each day in these three offices where I worked on a random basis. Once again, I had little time to keep a journal of what I did each day and how I managed to juggle three positions during those years, as I moved, physically, among my multiple office sites.

At the outset of my career, most of my time was spent in the Department of Medicine in the Fondren-Brown building of The Methodist Hospital (TMH), where I served as the Administrator for the department. My office was located one floor below that of Tony Gotto, M.D., the department’s chairman, to whom I reported. I spent a significant time each day double-stepping in the stairwells between the two floors. This action provided almost a daily opportunity to nod to Dr. Michael E. DeBakey as he, too, rushed from one floor to another between his surgeries and meetings. Most of the time, he recognized my existence. After-all, I theoretically reported to him in my role with the Heart Center, which he headed, as well as in central administration, in which he served as Chancellor, with President William Butler as my immediate supervisor.

DeBakey was, of course, a very interesting leader in medical science both nationally and internationally. Patients were as likely to arrive from Saudi Arabia as they were from every state in the Union as well as every nation in Latin America. I found it fascinating that directional signs throughout The Methodist Hospital were in three languages: English, Spanish and Arabic. There were many stories about the diversity of those seeking medical service with TMH. My favorite one was about the presence of the “king of the Gypsies.” Before his treatment began, a significant pre-deposit had to be made, in order to cover all of the items which would leave the premises when he and his followers dis-encamped upon completion of his medical procedures.

DeBakey, himself, was an imposing figure, racing up and down the stairwells or sitting at a boardroom table. He always wore cowboy boots, often white, with two-inch soles. They were probably very comfortable for standing over a surgery table for long periods and for giving him a taller stance at other times. MED had mellowed from what had been recorded, in earlier times, about his devastating comments toward transgressing colleagues. It was said that following his second marriage to Katrin, a former movie actress from Germany, he had become a calmer person. This change may have been due to the aging-maturing process, itself. His annual Christmas card to us always had a smiling photo of both of them, along with their daughter, Katrina.

My direct interactions with Dr. DeBakey were few. Most of them occurred through his sisters, Dr. Lois or Miss Selma. When I had to draft anything for him, I had to meet with one of them, usually, Dr. Lois, to obtain approval for what I had written. My longest interaction was in the preparation of materials to be presented at an NIH meeting we attended in Bethesda. Of course, he ignored everything I had prepared, but it was a pleasure to see him in action as the spokesman for medical science policy in the country.

The other way to communicate with MED was through Dr. Antonio Gotto, his medical protégé. Dr. Gotto, himself, was an internationally known physician in his specialty of arteriosclerosis. Tony had been a Rhodes Scholar and held a D.Phil. from Oxford as well as his M.D. from Vanderbilt. I reported to him on a daily basis at “five o’clock,” no matter what the actual time might be. Each day I called Jean, his personal assistant, to determine when “five o’clock” would occur on that particular day. Karen was never sure about when I would arrive home. That changed only after I began to commute by bus instead of by personal car. The METRO schedule became more important than Tony’s. There were certain, other “problems” with working through Jean to get to Tony, but that was, no doubt, part of her job. Our relationship did improve once I managed to establish with her the difference between “what Dr. Gotto might say” and “what Dr. Gotto actually said.”

My daily role with Dr. Tony Gotto was to run administrative interference for him with the heads of the various sub-specialties making up the Department of Medicine, which he chaired. I often experienced what might have been felt by a quarterback, even if I never played football. I believed that I knew what it might feel like to be sacked before throwing the ball, as the coach had wanted it to be done. The game included a variety of offensive and defensive strategies associated with the department’s budget cycles, when I negotiated with the section chiefs about their needs and demands. Since much of Medicine’s income depended upon the clinical fees derived from the private practice of its physicians, the discussions were often complex. I did manage, most of the time, for them not to be overly disappointed or angry after our negotiations were completed.

To add to the department’s financial complexity, we had to manipulate simultaneous incomes for diverse fiscal years. Baylor College of Medicine did not have its own teaching-hospital. Instead, the College, for the training of its medical students and interns, had special arrangements with TMC’s independent medical institutions. The College’s Department of Medicine relied upon the resources of The Methodist Hospital, the Veterans’ Affairs Hospital, the Ben Taub General Hospital of the Harris County Hospital District, and St. Luke’s Episcopal Hospital. Each organization had its own budget cycle, which varied among three periods: January through December, July through June or September through August. It was an ongoing challenge not to run out of funds for salaries of professional and support staff during any particular month. On the other hand, for most days, my managerial experiences were actually fun.

I could have continued to devote substantial effort to the administration of the Department of Medicine, but Mr. Johnson, BCM’s treasurer, had different ideas. When he learned, after several years, that my salary came from both Baylor and The Methodist Hospital, he demanded I should not have a divided loyalty or a potential conflict of interest. The Department of Medicine hired a full-time replacement for my position with it, and the College assumed the responsibility for my entire salary, although a small portion of it came from a grant from the NIH for our Heart Center, directed by doctors DeBakey and Gotto, in which I served as the Deputy Director for Administration. Fortunately, I had an Administrator who managed the day-to-day elements for the Center’s operation. I handled policy issues on behalf of MED and AG whenever problems arose for adjudication. Almost all of the investigators in the Heart Center were also members of the faculty of the Department of Medicine, so there was a high overlap of their clinical and research missions.

As Deputy Director for Administration of the National Heart & Blood Vessel Research & Demonstration Center, the major event I coordinated directly was the site visit by the NIH for the renewal of the multibillion-dollar grant funded by this federal agency. The site visit was a major event for both the NIH and the College. At the time, this was the largest site visit ever held by the NIH. We welcomed seventy-nine visitors to review our program!

Our Heart Center, colloquially known as The DeBakey Heart Center, had three divisions: Research, Education, and Demonstration. It was a challenge to aggregate all three elements into a united effort in the control of heart and blood vessel diseases. The seventy-nine visiting consultants met, over a three-day interval, with all of the research scientists, educators and clinicians involved in our project. I managed, with the help of a young administrative assistant, Bruce Stewart, to organize dozens of simultaneously scheduled presentations of what we were doing and expected to do if the grant were renewed. Cellphones were still in the future; fortunately, their precursors, two-way walkie-talkies, were available for the two of us to coordinate the movement of all of the faculty involved in these presentations.

Our application was renewed in excess of three million dollars, an amount that would be about ten times greater in current dollars. This, too, was a fun experience.

Looking at it one way, I was on the ground floor of what later became known as Information Technology. Indeed, my office as Director of Faculty and Research Resources was on the first floor of the main building for Baylor College of Medicine. My multiple tasks included the administration of all appointments to the faculty of the College, both regular and clinical, as well as with the management associated with research grants, beginning with the College’s official sign-off on all applications for external financial support and continuing through the coordination of various committees relating to faculty and research matters. Since I kept track of all of the College’s research and faculty, I could say I helped formulate the concept of information technology within the institution.

In order for a chairman to appoint someone to the department’s faculty, my signature was required in lieu of that of the President of the College or, later, the Dean for the Medical School. As with any growing academic institution, BCM kept modifying its organizational structure to meet changing conditions. Although I remained associated with the Office of the President, my immediate supervisor varied with my title of the moment.

Most of the time, I observed no problem with departmental requests for appointments to the faculty of the College. On rare occasion, I was puzzled with the applicant’s background qualifications relative to the rank to which the department wanted to appoint the person. My brief discussions with the chairman resulted with my appreciation for the action, or with a slight modification in titles bearing limiting conditions such as “Research, Clinical, Adjunct or Visiting.”

On my own delegated authority from the President, I could approve appointments at the level of Instructor or Assistant Professor. I had identical authority for all appointments with the modifying notation of “Research, Clinical, Adjunct or Visiting,” e.g., Research Associate Professor or Clinical Professor. However, for full appointments at the tenured level of Associate Professor or Professor, I had to coordinate a review by the Faculty Appointments and Promotions Committee, composed of selected departmental chairmen and senior faculty, which made its recommendations to the President for his approval.

In order to clarify the appointment process, I found it necessary to write a Faculty Handbook outlining the requirements and responsibilities associated with each type of appointment. At the time, the College had some 1,400 full-time, 100 part-time and 2,000 voluntary (Clinical) faculty. I also had oversight for the appointment of some 300 postdoctoral fellows. Many of these fellows were foreign nationals. Fortunately, a separate Office of International Services, for which I had oversight, handled their visa problems and offered other assistance they needed.

I also had oversight for a Faculty Records Office which managed all of the routine paperwork associated with an appointment. Additional information about each faculty member was retained in a computerized program I developed and maintained for this purpose. Each year, I prepared a Faculty Roster identifying all of our members as well as summary statistics for the College. As part of this overview, I designed a “flow chart” for each department to how its members advanced through the levels of Instructor, Assistant Professor, Associate Professor and Professor, beginning with their appointment to the faculty and completing with their departure for a new place. My training as a biochemist interested in metabolic pathways apparently had an entertaining result with regard to faculty pathways and the life of academic departments as organisms.

What I did for the organization of faculty appointments was replicated in what I did concerning the research in which they were engaged. Since my signature was required for every grant application seeking external support, it seemed logical for me to scan each proposal for its content – what the investigator intended to do and how much it would cost. I assigned “keywords” to each document and recorded all of the relevant information in my own Paradox-based data system.

It was not long before it was recognized I knew something about most of the research being conducted by the faculty and was able to respond to inquiries about their interests. Each year, I published a Grants Registry and Projects Thesaurus, summarizing the data showing who was doing what and their level of funding from all of the agencies providing financial support for these studies.

Another source for providing information about the research and clinical studies undertaken by the faculty was the annual Faculty Bibliography. Although I, personally, did the review and data capture for faculty appointments and research applications, I had a professional assistant in charge of the Bibliography. She obtained reprints from faculty members and inputted the information needed for the publication of this document. Those complaining about our omission of their own publications had only themselves to blame for not providing a copy to us for inclusion. I continued to be bemused by those who miss being included as a result of failing to participate in a process in which they had disdained any interest – until it affected them, directly.

Being able to support nascent research was among my favorite roles in administration. In my final position within the NIH, I had a responsibility for policies involving the Biomedical Research Support Grant providing institutional funds to medical schools and universities. Now I was the Principal Investigator for the BRSG awarded to BCM. Twice a year, I chaired the Faculty Research Committee which reviewed internal applications for modest support to initiate biological research. I enjoyed being able to help young investigators, directly. I also enjoyed helping them develop the fiscal and administrative components of their grant applications for external funding. It may be better to-give-rather-than-to-receive, but asking for support does have its own merits.

Biological research, especially in a medical school, often involves human subjects or animal models. The welfare of both types of subjects was of high concern to investigators, to fiscal supporters, and to the general public. All protocols involving human subjects had to be reviewed by a faculty committee to assure that ethical procedures were to be followed. Twice a month, our Human Subjects Review Committee met to exam every application in which such participation occurred. Fortunately, unlike the similar committee at the University of Massachusetts, I was not the chairman. At BCM, I served as the administrative liaison member and, later, affirmed, when I countersigned each application, that this review had been made and appropriate informed consent was included in the study.

A similar condition prevailed for the Animal Studies Review Committee, which I had chaired at Umass but here at Baylor was chaired by a member of the faculty involved with animal studies. Fortunately, the BCM Animal Care Facility with its nonhuman primate section did not have any problems with PETA or the public, in general. I admit I did not attend as many sessions of either the Human Subjects or the Animal Care committees as I might have; other professional events kept me well occupied.

Ultimately my role in research administration was taken over by a member of the faculty who was a clinical investigator and held an M.D. degree. This newly designated Vice President for Research, with his tenfold increased staff, now managed the efforts in which I, alone, had been engaged. As the College developed an expanded interest in maintaining computerized information and the establishment of a multi-staffed IT office, my own personalized system was set aside. Nevertheless, I remained as the Director of Faculty Appointments throughout the remainder of my career with BCM.

During the first month I was with Baylor College of Medicine, I had received a telephone call from Tom Malone, my first mentor at the NIH, who now held the position of Associate Director for Extramural Programs, once filled by John Sherman and then by Ronald Lamont-Havers. Tom, learning I had left the University of Massachusetts, inquired if I might be interested in returning to the NIH to be part of his office and become a potential senior member of the agency. I was strongly tempted at the time, having greatly enjoyed being part of the federal administration. However, I thought it would not be “good form,” having recently accepted positions with Dr. Gotto and Dr. Butler, to leave the College so abruptly. I declined Tom’s offer.

Had I accepted Tom’s proposition, my entire life – and that of my family – would have been radically different. Until my last year with the College, I was happily and gainfully employed. I have also been very content with all of the corollary results: my marriage, my children, grandchildren and great-grandchildren, and with my ministry at Christ the Good Shepherd and within the Diocese of Galveston-Houston as an ordained Permanent Deacon. None of this would have likely occurred if I had not remained with BCM in Houston, Texas.

However, my career with the College did have its unique puzzlement. I did little journal writing during my years in Houston. Evidently, I was too involved in trying to figure out what I was doing or, more important, what I was expected to be doing. I was never told what these expectations might be. By the end of that first year, I finally concluded I was hired to do what I thought needed to be done and if others seemed to accept my actions, the results would be sufficient for my employment to be continued. This conclusion was valid, perhaps, too valid.

For twenty-one years, from 1977 through 1998, my efforts were accepted by William Butler, M.D., the President of Baylor College of Medicine. There were slight changes in the person to whom I directly reported. In 1981, I no longer reported to Tony Gotto as his departmental Administrator and gave up any responsibility for managing the Department of Medicine on a day-to-day basis. Three years later, in 1984, I also relinquished administration of the DeBakey Heart Center, which had grown beyond its NIH funding as a research and demonstration center.

Having relinquished my management ties to the Department of Medicine, I retained, under a variety of titles, responsibility for research grant administration and for the appointment of faculty members to the medical school. My direct supervisors to whom I reported changed. At first, there was Tony Gorry, Ph.D., who was the Vice President for Information and Technology. When Gorry became a Vice President at Rice University, Bobby Alford, M.D., who remained as Chairman of the Department of Otorhinolaryngology, was appointed as the Dean of Medicine and became my direct superior. I have more than a dozen Christmas nutcrackers received from him over those years, as remembrances of our association.

When Bill Butler became President Emeritus in 1998, Ralph Feigin, M.D. was appointed as the new President of BCM. Unfortunately, I had annoyed Ralph when he was Chairman of the Department of Pediatrics. There had been times when he wanted to do things his way, even though this would have been inappropriate, administratively. I was able to accommodate his desires by offering alternatives; however, he was not pleased when I explained to him that what he wanted me to do, could not be done directly “his way.” Shortly after Feigin became President, Bobby Alford notified me that my contract would not be renewed for the following academic year. I would be given twelve months to find another position in one of the College’s departments. I decided July 1, 1999, would be a good date on which to retire.

At the end of June, Karen and I left for a two-week vacation in England. I never returned to work after my final vacation.

Although I did not maintain a diary during those years at BCM, I did – from time to time – enter a reflection into a small notebook I carried with me on trips to professional meetings or on site visits I continued to make for the NIH. Here are a few entries from those journals.

Tuesday, Oct. 2, 1979 (San Francisco, CA):
       Here I am in my hotel room, alone, in San Francisco, a city advertised as one of the most exciting cities in the country. Yes, it could be; but not when you’re alone and when the woman you love is 1,500 miles away. San Francisco is for couples. I learned that. It really isn’t a town for a single man who has no interest in picking up a woman – nor another man! Even if this town is known for that as well as its fog and charm.
       Right now I, myself, feel foggy – and not at all charming. I’m cool and damp, I cover, obscure, all that I touch. I crave a warmth to burn it all away. Perhaps in this writing I can.
      It’s now a few minutes after 10 o’clock. I just returned from getting a cheeseburger at a greasy-spoon a block from the hotel – over on O’Farrell. A safe distance away. A left turn, up the hill from the Hilton and a block to the right. “Never turn down hill!” The printed program for the meeting carries that admonition. Yet, down-hill doesn’t look all that bad. No more sleazy than some areas I’ve seen in Washington, D. C. I suppose “down-hill” never does look that bad when you are at the top.
        How do I feel right now? The question, of course, was prompted by an assessment of where I am on my own personal hill. The first response is: introspective. Why not? After all, if I didn’t feel that way, I probably would not be writing this right now.
       The next one is: puzzled. Yes, that’s a good term. It implies, to me, that I’m in several pieces that need putting back together. I want to see what the picture looks like. I am a jig-saw puzzle. Who cut up the pieces, I wonder? Was there once a whole picture and somehow it got cut up? Or is that what life is all about?
       Is God a puzzle maker, a master at constructing a jig-saw puzzle? We’re born all of a tumble, pieces scattered from a box. So many years are spent turning all of the pieces right-side-up. Then comes the time for finding the ones with a straight edge so that the frame can be built first. Finally, one hopes to build up the rest of the picture, to see what God intended right from the start.
      Where am I in all of this?
      I think I’ve turned over all of my pieces during the first thirty-eight years of my life. To be sure, some were turned over more recently. During the last five to six years. I’ve been building the frame, finding the straight edges. I’ve even found several inside pieces that seem to match. In fact, during the last six months, a number of aggregates have been constructed. They await the right time to be inserted into the picture.
      This is surely what “encounter with self” is all about – an attempt to turn the pieces the right way and begin the work of putting them together.
      What does my puzzle look like so far?
      There appear to be a lot of rosy colors. Karen has found most of them for me and put them together in large aggregates. In fact, she has concentrated on most of the bright pieces. I’ve been obsessed with the dark and dull ones. I see mainly my shortcomings.
     I see my anger, my annoyance, my intolerance. She sees my tenderness, my gentleness, my ability to comfort. In fact, she has pointed out how some of the dull, grey pieces are really lilac when put together.
     I see my drive to achieve, she sees my concern and need to help others. I serve two masters: me and others. I strive to please others so that I can please myself. I want others to accept me for who I am so that I can accept myself for who I am – and not for what I do.
     Yet, how can I separate the two? How can I really “be” without doing. Only God can be; all else must do in order to exist. Only God can exist without doing something to show there is existence. That’s an essential characteristic. God is; man does. Everything does. Atoms move; without movement nothing exists. A basic condition of physics, so I’m told. At absolute zero, there is no movement; at absolute zero, there is no existence as we think of existence.
     Everything must do something. Everything is known by what it does, by what it can do. Why should I be different?
      It’s ok for me to be accepted for what I can do. What I can do for others. It’s a necessary condition. The question then becomes: what should I do, what can I do? How do the two relate? Satisfaction comes from doing what should be done.
     I should help – rather than harm – other people. When I can help, and not harm, then I am accomplishing what I should do. Then I should be satisfied. Can I be satisfied?
     What a confusing web our, or at least, my words weave!
     And without benefit of a scotch!
     I brought back a cup of Sanka. It’s almost gone. Perhaps I should quit now. I’ve been writing for almost an hour. I should read for a while. Let my thoughts unwind. Begin a new web tomorrow.

I kept the notebook and used it once more, several months later.

Monday, January 14, 1980 (New York City, NY):
      In a way New York City is not much different from San Francisco. Yet there are subtle changes – in the environment and certainly in me.
     Yes, I’ve re-read my West Coast reflections, sitting now in the lobby of the Hotel Tudor. I really can’t abide my cell of a room. If it were in a monastery there would be more atmosphere! So here I am, Muzak bombarded, with people wandering by.
      I want my life to have some meaning. I’m not sure what meaning it really has now. Yes, I know it has meaning when it comes to Karen and me. My meaning in life is to love her, to be present to her when she needs me. That really means a lot to me. I so want her to need me – as I need her.
      This is what my life is all about.
      Strange. My life really began here in New York City, March 1957. Pictures come to mind. Karen in a blue-green coat on a Staten Island ferry boat. Her auburn hair blowing in the wind. I see her face, creamy in my mind’s eye. A Maureen O’Sullivan look! And her green eyes.
      I see her beside me at Rockefeller Center, at St Patrick’s, in a subway station late at night. At a restaurant called the Californian. At Sarde’s with “hambourger” that is four inches high and steak-tartare inside. At the Latin Quarter. Sleeping thorough the “Potting Shed.”
       Back then, Times Square held excitement and crispness, not the sleaziness of today’s walk among the porn shops and movie houses. That New York of twenty-three years ago is our New York. Then – a street vendor of hot pretzels offered a kingly repast; now I’m thankful he sells his wares and hands me the hot dough wrapped in a paper napkin.
      Then – there were lovely smoke-rings from the Camel’s ad on Times Square; now it’s been replaced by air pollution from cabs splashing dirty water on any who venture too near the curb. Each block held a new adventure; now a hint of violence, of ugliness. Baghdad-on-the-Hudson has become Tehran!

Two years later I returned for another site visit to San Francisco; the following words come from my notebook:

July 6, 1982 (San Francisco, CA):
      I’d forgotten what the smell of pine is like! A gentle fragrance, a tickle on the nose. A green aroma drawn deep into the lungs. I’m awash in it, here in an isolated spot in the Japanese Tea Garden of Golden Gate Park in San Francisco. How I wish Karen were here with me. A hint of her perfume would match the exotic odors of the candelabra pines around me. They stand like tiered birthday cakes, wedding cakes is more like it. In shades of green – shadow darkened, sun spotted. Delicate feathers waltzing in the breeze.
     A change of venue! To a post at the foot of a waterfall. Silver threads past a tapestry of red and green. Grey rocks spotted, like knurled hands, with lots of moss. Azure sky above the hill. The orange flash of a pagoda. Miniature daisies at my feet. Sunlight on my back. The Lord is good!
      How many shades of green are there!?
      For a moment the people had gone. I was alone with Karen and with God.
      The Tea House itself. With jasmine tea and a dish of nibble cookies/crackers. Crunch and sweet. And still the fragrance of pine.
It is difficult to exist in the now! I’ve spent the last hour or so looking at thousand-year-old jade carvings in the de Young museum. And now I’m sitting in the dappled sun-shade of the arboretum. I’ve tried to slow down, not to plan what I’m going to do next, how I’m going to invest my time to get the largest yield on the rental car. So much to see. Even more to perceive.
Why can I not rest here for awhile? To feel the cool breeze, to tune out the auto-noise of civilization which trespasses in this abode of rustling leaves, of a gibbering bird. Technological pollution of nature’s orchestra. Discordant blasts to stifle what I’d like to hear – to be.